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Modifiable Barriers and Facilitators for Breast Cancer Care: A Thematic Analysis of Patient and Provider Perspectives.

Publication ,  Journal Article
Fayanju, OM; Greenup, RA; Zafar, SY; Hyslop, T; Hwang, ES; Fish, LJ
Published in: J Surg Res
April 2023

INTRODUCTION: We sought to examine patient and provider perspectives regarding modifiable contributors to breast cancer treatment and to assess perceptual alignment between these two groups. MATERIALS: Participants were women≥18 y with stage 0-IV breast cancer who received all oncologic care in a single health system and physicians and advanced practice providers who provided medical, radiation, or surgical oncology care for breast cancer. All completed ∼45-min semistructured interviews that were recorded and transcribed verbatim. A 5-stage approach to thematic analysis was conducted, with emergent themes and exemplar quotes placed into clinical, psychological, social/logistical, financial, and lifestyle categories using a multilevel conceptual framework. RESULTS: Eighteen patients (9 Black, 9 White, and median age 60 y) and 10 providers (6 physicians and 4 advanced practice providers) were interviewed from May to November 2018. Both patients and providers perceived suboptimal communication, parking and transportation, and competing family-caregiving responsibilities as modifiable barriers to care. Treatment costs were cited by patients as barriers that were inadequately addressed even with referrals to financial counselors, but providers did not raise the issue of cost unless prompted by patients and did not feel prepared to discuss the topic when it arose. Providers cited obesity as a barrier to treatment, a view not shared by patients. CONCLUSIONS: Several modifiable factors were recognized by both patients and providers as either promoting or detracting from treatment receipt, but there was also significant incongruence and asymmetry. Alignment of provider and patient perceptions regarding contributors to guideline-concordant care receipt could mitigate disparities in breast cancer treatment and outcomes.

Duke Scholars

Published In

J Surg Res

DOI

EISSN

1095-8673

Publication Date

April 2023

Volume

284

Start / End Page

269 / 279

Location

United States

Related Subject Headings

  • Surgery
  • Referral and Consultation
  • Qualitative Research
  • Middle Aged
  • Male
  • Humans
  • Female
  • Communication
  • Breast Neoplasms
  • 3202 Clinical sciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Fayanju, O. M., Greenup, R. A., Zafar, S. Y., Hyslop, T., Hwang, E. S., & Fish, L. J. (2023). Modifiable Barriers and Facilitators for Breast Cancer Care: A Thematic Analysis of Patient and Provider Perspectives. J Surg Res, 284, 269–279. https://doi.org/10.1016/j.jss.2022.11.074
Fayanju, Oluwadamilola M., Rachel A. Greenup, S Yousuf Zafar, Terry Hyslop, E Shelley Hwang, and Laura J. Fish. “Modifiable Barriers and Facilitators for Breast Cancer Care: A Thematic Analysis of Patient and Provider Perspectives.J Surg Res 284 (April 2023): 269–79. https://doi.org/10.1016/j.jss.2022.11.074.
Fayanju OM, Greenup RA, Zafar SY, Hyslop T, Hwang ES, Fish LJ. Modifiable Barriers and Facilitators for Breast Cancer Care: A Thematic Analysis of Patient and Provider Perspectives. J Surg Res. 2023 Apr;284:269–79.
Fayanju, Oluwadamilola M., et al. “Modifiable Barriers and Facilitators for Breast Cancer Care: A Thematic Analysis of Patient and Provider Perspectives.J Surg Res, vol. 284, Apr. 2023, pp. 269–79. Pubmed, doi:10.1016/j.jss.2022.11.074.
Fayanju OM, Greenup RA, Zafar SY, Hyslop T, Hwang ES, Fish LJ. Modifiable Barriers and Facilitators for Breast Cancer Care: A Thematic Analysis of Patient and Provider Perspectives. J Surg Res. 2023 Apr;284:269–279.
Journal cover image

Published In

J Surg Res

DOI

EISSN

1095-8673

Publication Date

April 2023

Volume

284

Start / End Page

269 / 279

Location

United States

Related Subject Headings

  • Surgery
  • Referral and Consultation
  • Qualitative Research
  • Middle Aged
  • Male
  • Humans
  • Female
  • Communication
  • Breast Neoplasms
  • 3202 Clinical sciences